Basic Information
| Provider Information | |||||||||
| NPI: | 1174964282 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WHITE | ||||||||
| FirstName: | ROY | ||||||||
| MiddleName: | M. | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | II | ||||||||
| Credential: | LCMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9306 W 89TH ST | ||||||||
| Address2: | |||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662123833 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9137354368 | ||||||||
| FaxNumber: | 9136215730 | ||||||||
| Practice Location | |||||||||
| Address1: | 21350 W 153RD ST | ||||||||
| Address2: | |||||||||
| City: | OLATHE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660615413 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9133222400 | ||||||||
| FaxNumber: | 9136215730 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2013 | ||||||||
| LastUpdateDate: | 01/02/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 2471 | KS | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.